Vaginal Schwannoma in a case with uterine myoma.

Only 1% of gynecological neoplasms are vaginal, and mesenchymal tumors constitute only 2% of vaginal neoplasms. The most common form is leiomyomas. Schwannomas arise from the peripheral nerve sheath. We report a case of vaginal schwannoma associated with uterine myoma. A 52-year-old woman presented with lower abdominal pain and menorrhagia for a duration of 6 months. At sonographic examination, the patient was found to have uterine myomas and a solid mass measuring 5x4.5 cm beneath the vaginal wall. At laparotomy, the uterus with myoma was removed using our standard operation procedures. Surgical excision of the mass from vaginal aspect was also undertaken, and the histology demonstrated schwannoma. The tumor cells were vimentin (+), desmin (-), smooth muscle alpha-actin (-), HMB-45 (-), MART-1 (-) and S-100 (+). There is no evidence of recurrence during 6 months follow-up. The differential diagnosis of a mass in the vagina includes also schwannomas. Immunocytochemical labeling of the tumor cells is essential. Simple resection of the mass is the preferred method of treatment. Copyright 2010 Elsevier Inc. All rights reserved.